Effects of whole blood storage in a polyolefin blood bag on platelets for acute normovolemic hemodilution

Abstract

Acute normovolemic hemodilution (ANH) is a potential transfusion method for platelets, as well as for red blood cells. However, previous studies have shown that whole blood storage in ANH decreases platelet aggregability by 14.7–76.3% and that this decrease is not recovered by reinfusion. We investigated whether a new whole blood storage method for 6 h using a polyolefin bag, based on the platelet concentrates storage method, would maintain platelet function better than the conventional method using a polyvinyl chloride bag. We demonstrated that storage of whole blood in a polyolefin bag maintained ADP-induced aggregation rates at more than twofold higher than those in a polyvinyl chloride bag, and also significantly suppressed P-selectin expression, a platelet activation marker (ADP-induced aggregation rates: 24.6 ± 5.1% vs. 51.7 ± 11.5%, p = 0.002; P-selectin expression; 50.3 ± 8.4MFI vs. 31.6 ± 9.3MFI, p = 0.018). These results could be attributed to the high gas permeability of polyolefin, which lowered PCO2 and maintained a high pH with or without agitation. There were no significant changes in platelet count and red blood cell parameters due to the storage methods. Our results suggest that ANH using polyolefin bags is advantageous in improving hemostatic function compared to the conventional method.

Platelet function of whole blood after short‐term cold storage: A prospective in vitro observational study

“…The storage time of blood in ANH is a few hours, at most; therefore, a short storage time is needed to examine the optimal storage temperature in ANH, with an emphasis on platelet function. Thus, we set the storage time to 6 h, as in our previous study 27 of blood storage bags in ANH. The average anesthesia time for 3,407 non‐emergent cardiac surgeries (surgery requiring cardiopulmonary bypass or an off‐pump coronary artery bypass graft) at a single institution in the U.S. over a 3‐year period was 440 min 28 ; thus, the 6‐h storage time is a reasonable estimate of that seen in practice.…”